Platinum Chemotherapy Hypersensitivity: Prevalence and Management

Immunol Allergy Clin North Am. 2017 Nov;37(4):663-677. doi: 10.1016/j.iac.2017.06.003. Epub 2017 Aug 19.

Abstract

Hypersensitivity reactions to platinum agents are common. For carboplatin and cisplatin, the first hypersensitivity reaction typically occurs around the second and third re-exposure during the second line of therapy (eighth and ninth courses overall). For oxaliplatin, the first hypersensitivity reaction can occur throughout the treatment course. Skin testing helps risk stratify patients to appropriate desensitization protocols and assess risk for breakthrough HSRs during desensitization. A risk-stratification protocol using 3 serial skin tests and desensitization protocols enables patients with platinum agent hypersensitivity to receive first-line chemotherapy treatment safely.

Keywords: Carboplatin; Chemotherapy allergy; Chemotherapy desensitization; Chemotherapy hypersensitivity; Cisplatin; Oxaliplatin; Platinum agent.

Publication types

  • Review

MeSH terms

  • Allergens / immunology*
  • Antineoplastic Agents / immunology*
  • Antineoplastic Agents / therapeutic use
  • Desensitization, Immunologic / methods*
  • Drug Hypersensitivity / diagnosis
  • Drug Hypersensitivity / immunology*
  • Humans
  • Neoplasms / drug therapy*
  • Platinum Compounds / immunology*
  • Platinum Compounds / therapeutic use
  • Skin Tests

Substances

  • Allergens
  • Antineoplastic Agents
  • Platinum Compounds